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GENERAL ARTICLES

Administration of 100% Oxygen Before Removal of the Laryngeal Mask Airway Does Not Affect Postanesthetic Arterial Partial Pressure of Oxygen

Markus Renner, MD^*, Matthias Hohlrieder, MD, Thomas Wölk, MD^*, Friedrich Pühringer, MD^*, Axel T. Kleinsasser, MD, Christian Keller, MD, and Arnulf Benzer, MD

Department of Anesthesiology and Critical Care Medicine, *Klinikum am Steinenberg, Reutlingen, Germany; and The Leopold-Franzens University of Innsbruck, Innsbruck, Austria

Address correspondence and reprint requests to Arnulf Benzer, MD, Department of Anesthesiology, Critical Care and Emergency Medicine, The Leopold-Franzens University of Innsbruck, Anichstrasse 35, 6020 Innsbruck, Austria. Address e-mail to arnulf.benzer{at}uibk.ac.at

Breathing 100% oxygen at the end of general anesthesia has been shown to worsen postoperative pulmonary gas exchange when an endotracheal tube is used. Counter measures, such as high positive end-expiratory pressure or the vital-capacity maneuver, may limit this effect. Such strategies, however, may be impracticable, or even contraindicated, when the laryngeal mask airway (LMA) is used. Because of the vast differences in design between the LMA and endotracheal tube, we examined postanesthetic blood gas tensions in patients after emergence from anesthesia breathing oxygen via LMA. Sixty-four ASA physical status I–II patients undergoing general anesthesia for 60 min with LMA were randomly assigned to receive either 100% or 30% oxygen during emergence from anesthesia and removal of LMA. Postoperative blood gas measurements were taken at 30 and 60 min after removal of the LMA. At either measurement, patients treated with 100% oxygen essentially had the same arterial partial pressure of oxygen (60-min measurement: 83 ± 8 versus 85 ± 7 mm Hg [mean ± SD], P = 0.14) as those treated with 30% oxygen. We conclude that breathing 100% oxygen at the end of general anesthesia does not worsen postoperative pulmonary gas exchange when an LMA is used.

IMPLICATIONS: The endotracheal tube and laryngeal mask airway are substantially different artificial airways used to ventilate the lungs of anesthetized patients. Breathing 100% oxygen before removing the endotracheal tube results in lung function defects. This study shows that oxygen breathing before removing the laryngeal mask airway has no effect on pulmonary function.

This article has been cited by other articles:

				K. Goldmann, C. Roettger, and H. Wulf Use of the ProSealTM laryngeal mask airway for pressure-controlled ventilation with and without positive end-expiratory pressure in paediatric patients: a randomized, controlled study Br. J. Anaesth., December 1, 2005; 95(6): 831 - 834. [Abstract] [Full Text] [PDF]

Anesthesia & Analgesia® is published for the International Anesthesia Research Society® by Lippincott Williams & Wilkins with the assistance of Stanford University Libraries' HighWire Press®. Copyright 2006 by the International Anesthesia Research Society. Online ISSN: 1526-7598   Print ISSN: 0003-2999